Divine Intervention Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE INTERVENTION HEALTHCARE, INC

Practice address

2158 45TH St Ste 303
Highland, IN 46322-3742

Phone

(708) 821-5448

Fax

(708) 566-5293

NPI assigned

Nov 15, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sandrena Armetta Harris, RN

Title

Administrator

Phone

(708) 821-5448

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258243200000",
    "number": "1093042863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 45TH ST STE 303",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223742",
            "telephone_number": "708-821-5448",
            "fax_number": "708-566-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 45TH ST STE 303",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223742",
            "telephone_number": "708-821-5448",
            "fax_number": "708-566-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INTERVENTION HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-15",
        "last_updated": "2009-11-15",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "SANDRENA",
        "authorized_official_middle_name": "ARMETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-821-5448",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.